Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?

Background: Over the last 20 years various techniques have been developed striving for safer and more durable pulmonary vein isolation (PVI). The three most commonly used tools are pulmonary vein ablation catheter (PVAC) and cryoballoon (‘single-shot’ techniques), and point-by-point (PBP) radiofrequ...

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Autores principales:	S.A. Reddy, S.L. Nethercott, B.V. Khialani, M.S. Virdee
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Atrial fibrillation Catheter ablation 3D mapping Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/d54eb3691e3041368e344442d3395497
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spelling	oai:doaj.org-article:d54eb3691e3041368e344442d33954972021-12-02T04:58:03ZPulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?0019-483210.1016/j.ihj.2021.10.012https://doaj.org/article/d54eb3691e3041368e344442d33954972021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0019483221002315https://doaj.org/toc/0019-4832Background: Over the last 20 years various techniques have been developed striving for safer and more durable pulmonary vein isolation (PVI). The three most commonly used tools are pulmonary vein ablation catheter (PVAC) and cryoballoon (‘single-shot’ techniques), and point-by-point (PBP) radiofrequency ablation using 3D electroanatomical mapping (EAM). Objective: Evaluate the safety and efficacy of the different techniques in an unselected population undergoing de-novo ablation for persistent or paroxysmal atrial fibrillation (AF) at Royal Papworth Hospital (RPH). Method: Retrospective, single-centre study of consecutive AF ablations at RPH between March 2017 and April 2018. Demographic, procedural and outcome data were analysed. Results: Over the study period 329 first-time PVI procedures were performed. 37.4% were performed using PBP, 39.8% using cryoballoon and 22.8% using PVAC. There was no significant difference in age or sex between different ablation technique groups. 238 procedures were performed for paroxysmal AF and 91 for persistent AF. A higher proportion of the persistent cases were performed using point-by-point techniques compared to paroxysmal cases (58.2% vs 29.0%, p < 0.05).Procedural times were significantly longer in the group undergoing PBP ablation compared to cryoballoon or PVAC. However, there was no statistically significant difference in 12-month freedom from symptomatic AF or procedural complications between the groups. Conclusions: PBP, PVAC and cryoballoon AF ablation all appeared equally efficacious in an unselected population, though PVAC and cryoballoon procedures were shorter. All procedures were associated with a low adverse event rate. Prospective examination is required to substantiate this finding.S.A. ReddyS.L. NethercottB.V. KhialaniM.S. VirdeeElsevierarticleAtrial fibrillationCatheter ablation3D mappingSurgeryRD1-811Diseases of the circulatory (Cardiovascular) systemRC666-701ENIndian Heart Journal, Vol 73, Iss 6, Pp 718-724 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Atrial fibrillation Catheter ablation 3D mapping Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Atrial fibrillation Catheter ablation 3D mapping Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701 S.A. Reddy S.L. Nethercott B.V. Khialani M.S. Virdee Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
description	Background: Over the last 20 years various techniques have been developed striving for safer and more durable pulmonary vein isolation (PVI). The three most commonly used tools are pulmonary vein ablation catheter (PVAC) and cryoballoon (‘single-shot’ techniques), and point-by-point (PBP) radiofrequency ablation using 3D electroanatomical mapping (EAM). Objective: Evaluate the safety and efficacy of the different techniques in an unselected population undergoing de-novo ablation for persistent or paroxysmal atrial fibrillation (AF) at Royal Papworth Hospital (RPH). Method: Retrospective, single-centre study of consecutive AF ablations at RPH between March 2017 and April 2018. Demographic, procedural and outcome data were analysed. Results: Over the study period 329 first-time PVI procedures were performed. 37.4% were performed using PBP, 39.8% using cryoballoon and 22.8% using PVAC. There was no significant difference in age or sex between different ablation technique groups. 238 procedures were performed for paroxysmal AF and 91 for persistent AF. A higher proportion of the persistent cases were performed using point-by-point techniques compared to paroxysmal cases (58.2% vs 29.0%, p < 0.05).Procedural times were significantly longer in the group undergoing PBP ablation compared to cryoballoon or PVAC. However, there was no statistically significant difference in 12-month freedom from symptomatic AF or procedural complications between the groups. Conclusions: PBP, PVAC and cryoballoon AF ablation all appeared equally efficacious in an unselected population, though PVAC and cryoballoon procedures were shorter. All procedures were associated with a low adverse event rate. Prospective examination is required to substantiate this finding.
format	article
author	S.A. Reddy S.L. Nethercott B.V. Khialani M.S. Virdee
author_facet	S.A. Reddy S.L. Nethercott B.V. Khialani M.S. Virdee
author_sort	S.A. Reddy
title	Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
title_short	Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
title_full	Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
title_fullStr	Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
title_full_unstemmed	Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?
title_sort	pulmonary vein isolation for atrial fibrillation: does ablation technique influence outcome?
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/d54eb3691e3041368e344442d3395497
work_keys_str_mv	AT sareddy pulmonaryveinisolationforatrialfibrillationdoesablationtechniqueinfluenceoutcome AT slnethercott pulmonaryveinisolationforatrialfibrillationdoesablationtechniqueinfluenceoutcome AT bvkhialani pulmonaryveinisolationforatrialfibrillationdoesablationtechniqueinfluenceoutcome AT msvirdee pulmonaryveinisolationforatrialfibrillationdoesablationtechniqueinfluenceoutcome
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Pulmonary vein isolation for atrial fibrillation: Does ablation technique influence outcome?

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